-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, Mkv1SWIK9xYixkNaFzVwKxx4NrWJGVnxRmM5Zajs/Yk7aoKkmgL6d5nA8JZeI3cZ VHTAh1rHCiEHyGhQ5/DGHw== 0001140361-09-017840.txt : 20090804 0001140361-09-017840.hdr.sgml : 20090804 20090804172739 ACCESSION NUMBER: 0001140361-09-017840 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090731 FILED AS OF DATE: 20090804 DATE AS OF CHANGE: 20090804 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: USA TECHNOLOGIES INC CENTRAL INDEX KEY: 0000896429 STANDARD INDUSTRIAL CLASSIFICATION: CALCULATING & ACCOUNTING MACHINES (NO ELECTRONIC COMPUTERS) [3578] IRS NUMBER: 232679963 STATE OF INCORPORATION: PA FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 100 DEERFIELD LANE STREET 2: SUITE 140 CITY: MALVERN STATE: PA ZIP: 19355 BUSINESS PHONE: 6109890340 MAIL ADDRESS: STREET 1: 100 DEERFIELD LANE STREET 2: SUITE 140 CITY: MALVERN STATE: PA ZIP: 19355 FORMER COMPANY: FORMER CONFORMED NAME: USA ENTERTAINMENT CENTER INC DATE OF NAME CHANGE: 19931029 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JENSEN GEORGE R JR CENTRAL INDEX KEY: 0001202180 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33365 FILM NUMBER: 09984723 MAIL ADDRESS: STREET 1: 517 LEGION RD CITY: WEST CHESTER STATE: PA ZIP: 19382 4 1 doc1.xml FORM 4 X0303 4 2009-07-31 0 0000896429 USA TECHNOLOGIES INC USAT 0001202180 JENSEN GEORGE R JR 100 DEERFIELD LN SUITE 140 MALVERN PA 19355 1 1 0 0 CEO Common Stock 2009-07-31 4 M 0 15000 2.00 A 95802 D Common Stock 2009-07-31 4 G 0 30000 0 D 65802 D Common Stock 35429 I By Trust Common Stock 2000 I By Spouse Subscription Rights (Right to Buy) 2.00 2009-07-31 4 M 0 15000 0 D 2009-07-13 2009-07-31 Common Stock and Warrants 30000 0 D Warrants 2.20 2009-07-31 4 M 0 15000 0 A 2010-01-01 2011-12-31 Common Stock 15000 15000 D Series A Convertible Preferred Stock 2008-10-10 Common Stock 80000 D Non-Qualified Stock Option (Right to Buy) 7.50 Common Stock 75000 75000 D Represents shares of common stock issued to Mr. Jensen upon exercise of his subscription rights which were issued by the Company pro-rata to all shareholders of record as of July 10, 2009. Represents 15,000 shares gifted to each of his sons, Ronald and Burton. Each subscription right entitled the holder to subscribe for one share of common stock at the subscription price of $2.00 per share and to receive one warrant to purchase one additional share of common stock at $2.20 for a period of two years following January 1, 2010. Represents warrants issued to Mr. Jensen upon exercise of his subscription rights. Each share of Series A Convertible Preferred Stock is convertible into a hundredth of a share of Common Stock, and does not have an expiration date. The options may be excercised at any time within five years of vesting. The options vested as follows: 25,000 on 5/11/06, 25,000 on 6/30/07 and 25,000 on 6/30/08. /s/ George R. Jensen Jr. 2009-08-04 -----END PRIVACY-ENHANCED MESSAGE-----